HANGOVERS 

Hangovers represent the very unpleasant side-effects of drinking too much alcohol. Alcohol dehydrates the cells, removes fluid from the blood, swells the cranial arteries and irritates the gastrointestinal tract.  

The common hangover includes some, or all, of the following: headache, poor sense of overall wellbeing, sensitivity to light and sound, diarrhoea, loss of appetite, trembling, nausea, fatigue, increased heart rate and blood pressure, dehydration, inability to concentrate, anxiety, difficulty sleeping, and weakness.  

While it was long believed that many hangover side effects were caused by dehydration, a new study has revealed that while dehydration contributes to hangover symptoms, inflammation is responsible for dizziness, headache, nausea, and brain fog.  

Suffering from a hangover, patients are fortunate that there are several natural and OTC treatment options to alleviate symptoms: 

• Painkillers – anti-inflammatories like NSAIDs, ibuprofen, and naproxen 
• Anti-diarrhoeal medicines – loperamide and bismuth subsalicylate 
• Oral rehydration therapy – glucose-electrolyte oral rehydration solution 
• Herbal supplements – Silybum marianus (milk thistle), Althaea officinalis (marshmallow), and Ulmusfulva (slippery elm) 
• Homeopathic remedies – Lupulus humulus, Lobelia inflate, and Nux vomica 

INDIGESTION 

Also known as dyspepsia, indigestion is a functional condition in which the gastrointestinal organs, primarily the stomach and first part of the small intestine (and occasionally the oesophagus), function abnormally. Heartburn is a symptom caused by reflux of acidic stomach contents into the oesophagus, resulting in irritation and burning. Other possible symptoms include pain, burning, and discomfort in the upper belly or abdomen, feeling full too soon while eating, feeling bloated, poor appetite, burping and loud stomach gurgling, acidic taste, nausea or vomiting, constipation, diarrhoea, and flatulence.  

While indigestion may be the result of a disease or an ulcer in the digestive tract, most often it is the result of eating too much, eating too quickly, or eating high-fat foods, all of which are common over the festive season.  

The first step to easing patients’ indigestion is to encourage them to make lifestyle changes. These include avoiding trigger foods (fried foods, chocolate, onion, garlic, etc.) reducing or eliminating alcohol and caffeine, eating 5-6 small meals a day instead of three large meals, avoiding certain pain relievers (aspirin, ibuprofen, naproxen sodium, etc.), finding alternatives for medications that trigger indigestion, and controlling stress and anxiety.  

Depending on the cause of indigestion there are several medications available including: antacids, H2 blockers, proton pump inhibitors (PPIs), antidepressants, prokinetics, and antibiotics. Psychological therapies include cognitive behavioural therapy, biofeedback, hypnotherapy, and relaxation therapy.  

GOUT 

Historically, gout was sometimes called the “disease of kings” as it was blamed on an overindulgence in rich food and alcohol. Although scientists have since discovered gout is caused by increased levels of uric acid in body fluids, certain foods do exacerbate the condition. Animal proteins such as red meat, pork, oily fish, and shellfish are high in purines, while alcohol reduces the metabolism of uric acid and can make problems with gout more significant. Again, all things patients are enjoying during the holidays.  

Treatment of acute gout attacks typically involves rest, splinting, and anti-inflammatory medications, advised orthopaedic surgeon Dr John Erickson. “Naproxen and ibuprofen are examples of common OTC NSAIDs used in the treatment of gout. Indomethacin and prednisone are stronger prescription anti-inflammatory medications. Colchicine is another commonly prescribed medicine for gout attacks. A corticosteroid injection into the joint can also be used to reduce the inflammation from gout.”  

DEPRESSION 

While “holiday blues” or “holiday depression” might not be official clinical terms, stress and depression over the festive season is a very real thing. While most celebrate with parties and social gatherings with family and friends, for many it is a time of painful reflection, loneliness, sadness, anger, anxiety, and depression. There are several reasons patients may experience holiday blues: social isolation, grieving loved ones, financial stress, unrealistic expectations, over-commercialisation, family tension, lack of sleep, excess eating and alcohol use.  

Ideally, treatment should be proactive. Encourage patients to identify potential triggers so they’re prepared to face them. Practical solutions you can offer include: 

• Make realistic expectations for the holiday season, set realistic goals, and be realistic about what you can do. 
• Don’t overspend. Set a budget and stick to it. 
• Be selective when choosing your engagements. 
• Share the responsibilities of holiday tasks. 
• Eat healthily, exercise, and get enough rest. 
• Limit alcohol consumption. 
• Spend time outside in the sun. 
• Don’t compare this season with prior ones. 
• If you’re lonely, try volunteering. 
• Make time for yourself. 
• Seek professional help. 

There are also several supplements that may help with stress and trouble sleeping.